J Korean Fract Soc.  2016 Jul;29(3):221-231. 10.12671/jkfs.2016.29.3.221.

Surgical Treatment for Displaced Intra-Articular Calcaneal Fractures

• Park CH
• Shon OJ

• KMID: 2344096
• DOI: http://doi.org/10.12671/jkfs.2016.29.3.221

Abstract

Calcaneal fractures are the most common type of tarsal fracture, and comminuted and bursting fractures are common due to the anatomic characteristics of the calcaneus. Assessment and treatment of calcaneal fractures has improved significantly over time. Despite advancements in surgical techniques and equipment, these fractures remain difficult to treat. In this review article, the physiopathology, classification, and surgical treatments of displaced intra-articular calcaneal fractures are updated.

Keyword

Calcaneus; Fractures; Surgery

MeSH Terms

Calcaneus
Classification

Figure

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  Fig. 1 (A) Arthroscopically guided reduction of the calcaneus fracture. Arthroscopic procedures are performed using the anterolateral and central portals. (B) Arthroscopic checking of the posterior facet. The intra-articular step is checked on the posterior facet. (C) The step is reduced with percutaneous leverage of the tuberosity fragment.

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  Fig. 2 Whole subtalar joint is exposed using the extensile lateral approach.

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  Fig. 3 Anatomical low-profile plate is placed after reduction of the posterior facet using the extensile lateral approach.

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  Fig. 4 Extended sinus tarsi approach. (A) After incision of the calcaneofibular ligament (CFL) at the fibular attachment, the subtalar joint is widely exposed. (B) A incised CFL is repaired using a 2.7-mm suture anchor.

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  Fig. 5 (A) Open subtalar arthroscopy is performed after reduction and temporary K-wire fixation of the fragments using a sinus tarsi approach. (B) The intra-articular step is checked on the posterior facet. (C) The step is reduced with percutaneous leverage of the tuberosity fragment.

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  Fig. 6 Allograft bone chips are inserted at the bone defect site after reduction of the posterior facet.

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  Fig. 7 Negative pressure wound therapy is applied to assist wound healing after the extensile lateral approach.

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